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1.
BMC Infect Dis ; 19(1): 1062, 2019 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-31852453

RESUMO

BACKGROUND: To investigate the cumulative incidence of and factors associated with mortality among patients with infective endocarditis (IE) at Thailand's largest national tertiary referral center. METHODS: Medical charts of adult patients diagnosed with IE by Duke criteria at Siriraj Hospital during January 2005 to May 2015 were retrospectively reviewed. RESULTS: Of 380 patients, 66.3% had definite IE, and 81.3% had native valve IE (NVE). Cumulative IE incidence was 5.67/1000 admissions. The most common pathogens were viridans group streptococci (VGS) (39.7%), methicillin-sensitive Staphylococcus aureus (MSSA) (13.1%), and beta-hemolytic streptococci (11.5%) in NVE; and, MSSA (20.3%), VGS (20.3%), and Enterococcus spp. (16.9%) in prosthetic valve (PVE) or device-related IE (DRIE). Overall in-hospital mortality was 18.4%. Mortality was significantly higher in PVE/DRIE than in NVE (26.8% vs. 16.5%, p = 0.047). End-stage renal disease (ESRD) (aOR: 9.43, 95% CI: 2.36-37.70), diabetes mellitus (DM) (aOR: 2.81, 95% CI: 1.06-7.49), neurological complication (aOR: 14.16, 95% CI: 5.11-39.22), congestive heart failure (aOR: 4.32, 95% CI: 1.91-9.75), hospital-acquired infection (aOR: 3.78, 95% CI: 1.66-8.57), renal complication (aOR: 3.12, 95%CI: 1.32-7.37), and other complication during admission (aOR: 3.28, 95% CI: 1.41-7.61) were independently associated with mortality. CONCLUSIONS: The incidence of IE, and the mortality rate among those diagnosed with IE are both increasing in Thailand - particularly among those with PVE or DRIE. End-stage renal disease, diabetes mellitus, and development of IE-related complications during admission were found to be independent predictors of mortality.


Assuntos
Endocardite Bacteriana/epidemiologia , Enterococcus/isolamento & purificação , Infecções Estafilocócicas/epidemiologia , Staphylococcus aureus/isolamento & purificação , Infecções Estreptocócicas/epidemiologia , Streptococcus/isolamento & purificação , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Infecção Hospitalar , Endocardite Bacteriana/microbiologia , Endocardite Bacteriana/mortalidade , Feminino , Mortalidade Hospitalar , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Infecções Estafilocócicas/microbiologia , Infecções Estafilocócicas/mortalidade , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/mortalidade , Tailândia/epidemiologia , Estreptococos Viridans/isolamento & purificação , Adulto Jovem
3.
Res Vet Sci ; 125: 82-88, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31174167

RESUMO

Strangles is a highly prevalent, extremely contagious, and occasionally lethal infectious disease affecting horses worldwide. Prophylactic antibiotics are ineffective in prevention of disease but are recommended for exposed horses at the first sign of fever and any horse obviously ill from strangles or with complications and there is an urgent need of a cost-effective, safe, efficacious vaccine. In the present study, we sought to develop effective vaccines by fusing the Streptococcus equi subspecies equi (S. equi) antigen SeM with the flagellin of Salmonella abortus equi FljB. We also explored the immunogenicity and efficacy of this candidate vaccine in mice and horses by intramuscular injection. Mice and horses immunized with FljB-SeM DNA vaccine showed high levels of specific antibody and increased production of IFN-γ and IL-4. This confirmed that both Th1 and Th2 type responses were induced. The mice survival rate was significantly higher after immunization with FljB-SeM than with SeM alone. The FljB-SeM DNA could strengthen both the Th1 and Th2 immune responses compared to SeM and could provide better protection against S. equi. This technique could help develop a candidate vaccine for S. equi infection.


Assuntos
Anticorpos Antibacterianos/imunologia , Vacinas Bacterianas/imunologia , Doenças dos Cavalos/prevenção & controle , Infecções Estreptocócicas/veterinária , Streptococcus equi/imunologia , Vacinas de DNA/imunologia , Animais , Anticorpos Antibacterianos/sangue , Antígenos de Bactérias/imunologia , Proteínas de Bactérias/imunologia , Feminino , Flagelina/imunologia , Imunofluorescência/veterinária , Doenças dos Cavalos/imunologia , Cavalos , Imunoglobulina G/sangue , Imunoglobulina G/imunologia , Injeções Intramusculares/veterinária , Interferon gama/sangue , Interleucina-4/sangue , Cinética , Camundongos , Camundongos Endogâmicos C57BL , Plasmídeos , Organismos Livres de Patógenos Específicos , Infecções Estreptocócicas/mortalidade , Infecções Estreptocócicas/prevenção & controle , Streptococcus equi/genética , Taxa de Sobrevida , Vacinação/veterinária
4.
Nat Commun ; 10(1): 2586, 2019 06 13.
Artigo em Inglês | MEDLINE | ID: mdl-31197146

RESUMO

Bacteria control gene expression in concert with their population density by a process called quorum sensing, which is modulated by bacterial chemical signals and environmental factors. In the human pathogen Streptococcus pyogenes, production of secreted virulence factor SpeB is controlled by a quorum-sensing pathway and environmental pH. The quorum-sensing pathway consists of a secreted leaderless peptide signal (SIP), and its cognate receptor RopB. Here, we report that the SIP quorum-sensing pathway has a pH-sensing mechanism operative through a pH-sensitive histidine switch located at the base of the SIP-binding pocket of RopB. Environmental acidification induces protonation of His144 and reorganization of hydrogen bonding networks in RopB, which facilitates SIP recognition. The convergence of two disparate signals in the SIP signaling pathway results in induction of SpeB production and increased bacterial virulence. Our findings provide a model for investigating analogous crosstalk in other microorganisms.


Assuntos
Proteínas de Bactérias/metabolismo , Exotoxinas/metabolismo , Regulação Bacteriana da Expressão Gênica/fisiologia , Percepção de Quorum/fisiologia , Infecções Estreptocócicas/microbiologia , Streptococcus pyogenes/patogenicidade , Animais , Modelos Animais de Doenças , Feminino , Histidina/metabolismo , Humanos , Concentração de Íons de Hidrogênio , Camundongos , Sinais Direcionadores de Proteínas/fisiologia , Transdução de Sinais/fisiologia , Infecções Estreptocócicas/mortalidade , Streptococcus pyogenes/fisiologia , Virulência/fisiologia
5.
Zhonghua Er Ke Za Zhi ; 57(6): 452-457, 2019 Jun 02.
Artigo em Chinês | MEDLINE | ID: mdl-31216803

RESUMO

Objective: To explore the clinical features, the risk factors of mortality and drug resistance of the isolates in patients with group B streptococcus (GBS) meningitis. Methods: A retrospective analysis was performed in 96 children with GBS meningitis (46 males and 50 females) at Beijing Children's Hospital Affiliated to Capital Medical University from January 2013 to October 2017. The clinical characteristics, prognosis and drug resistance were reviewed and analyzed. According to the onset time, the patients were divided into early onset disease (EOD, 0-6 days), late onset disease (LOD, 7-89 days) and very late onset disease (VLOD, 90 days-16 years), the clinical features were compared. According to the results of cranial imaging examination, the patients were divided into two groups: those with neurological complications and those without neurological complications. The influencing factors of neurological complications were analyzed. According to the outcome of 28 days after discharge, patients were divided into death group and survival group. The risk factors of mortality were analyzed by multivariate Logistic regression analysis. Non-numeric variables were analyzed with χ(2) test or Fisher's exact test. Numeric variable between groups were compared with nonparametric test. Results: A total of 96 patients were enrolled, including 18 (19%) EOD, 71 (74%) LOD and 7 (7%) VLOD cases. The median age of EOD cases was 2 days, with a range from 0 to 6 days. The median age of LOD cases was 31 days, with a range from 7 to 81 days. The median age of VLOD cases was 153 days, with a range from 95 to 214 days. Before the onset of the disease, the mother had mastitis in 6 cases and premature rupture of membranes in 6 cases. The common clinical manifestations of patients were fever (95%, 91/96), anorexia (65%, 62/96), seizure (56%, 54/96), and consciousness changes (36%, 35/96). The differences were statistically significant in gender (13/18 vs. 28/71 vs. 5/7, χ(2)=7.705, P=0.024), the number of cases who was admitted to intensive care unit (ICU) (5/18 vs. 31/71 vs. 0, χ(2)=6.065, P=0.042) and peripheral blood leukocyte (12(4, 18)×10(9)/L vs. 6(3, 11)×10(9)/L vs. 13(6, 17)×10(9)/L, H=9.885, P=0.007) in EOD group, LOD group and VLOD group. Cranial imaging was performed in 94 patients, 60 patients (64%) developed neurological complications, including subdural effusion (31/94, 33%), followed by intracranial hemorrhage (26/94, 28%), cerebral softening (19/94, 20%), cerebral atrophy (15/94, 16%), ependinitis (8/94, 9%) and hydrocephalus (4/94, 4%). By univariate χ(2) test analysis, seizure (63% (38/60) vs.41% (14/34), χ(2)=4.310, P=0.038) was a risk factor of neurological complications. Within 28 days after discharge, 88 patients survived and 8 patients died, with a fatality rate of 8%. The independent risk factors for the death were septic shock (OR: 9.548, 95% CI 1.439-63.356, P=0.019) and respiratory failure (OR: 7.053, 95% CI 1.160-42.888, P=0.034). All of isolates were susceptible to penicillin (68/68), ceftriaxone (47/47), cefepime (50/50), vancomycin (60/60) and linezolid (54/54), while the rates of resistance to tetracycline, levofloxacin, clindamycin and erythromycin were 5/12, 17/45, 38/46 and 32/37, respectively. Conclusions: The main type of GBS meningitis is late onset cases. The incidence of neurological complications was high. The independent risk factors for death were septic shock and respiratory failure. The strains were severely resistant to clindamycin and erythromycin.


Assuntos
Meningites Bacterianas/diagnóstico , Doenças do Sistema Nervoso/epidemiologia , Infecções Estreptocócicas/diagnóstico , Idade de Início , Antibacterianos/uso terapêutico , Criança , Feminino , Humanos , Incidência , Transtornos de Início Tardio , Masculino , Meningites Bacterianas/tratamento farmacológico , Meningites Bacterianas/mortalidade , Testes de Sensibilidade Microbiana , Doenças do Sistema Nervoso/complicações , Estudos Retrospectivos , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/mortalidade
6.
Gen Thorac Cardiovasc Surg ; 67(12): 1030-1037, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31049817

RESUMO

BACKGROUND: Mitral valve repair has been proved to provide better outcomes when compared with replacement in degenerative disease. However, it is still unclear that benefits of repair still remain in active endocarditis. Patient clinical conditions and severity of tissue destruction might limit successful durable repair. METHODS: Of all 247 patients who received surgery during active phase of native left-sided endocarditis from Jan 2006 to Dec 2017, 114 had mitral valve procedures due to active infection of mitral valve apparatus (38 repair and 76 replacement). Perioperative data and mid-term outcomes were retrospectively compared. RESULTS: Mean age was 46.4 years old. Repair group had significantly less patients with NYHA class IV (18.4% vs 56.6%, p = 0.001). Both groups had preserved ejection fraction but accompanied by severe pulmonary hypertension. Major organism was streptococci (50%) and timing of surgery was 11 days after diagnosis. Bypass and cross-clamp time were similar but repair group had significantly less combined procedures. Bi-leaflet involvement was common (47.4% vs 57.6%) and valve lesions were comparable. There was 13.2% of postoperative moderate to severe mitral regurgitation in repair group without recurrent endocarditis. Repair group tended to have better 5-year survival estimates (91.6% vs 70.0%, p = 0.08) with comparable reoperation rate (7.9% vs 2.6%). By logistic regression analysis, mitral valve replacement was more likely to be performed in patients with decompensated heart failure and combined procedures. CONCLUSIONS: Mitral valve repair during active endocarditis can be safely performed with good mid-term outcomes, especially in selected group of patients without extremely high surgical risk.


Assuntos
Endocardite Bacteriana/cirurgia , Endocardite/cirurgia , Insuficiência da Valva Mitral/cirurgia , Valva Mitral/cirurgia , Infecções Estreptocócicas/cirurgia , Adulto , Endocardite/microbiologia , Endocardite/mortalidade , Endocardite Bacteriana/microbiologia , Endocardite Bacteriana/mortalidade , Feminino , Implante de Prótese de Valva Cardíaca , Humanos , Japão , Masculino , Pessoa de Meia-Idade , Insuficiência da Valva Mitral/mortalidade , Período Perioperatório , Reimplante , Estudos Retrospectivos , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/mortalidade , Análise de Sobrevida , Resultado do Tratamento
7.
Vet Microbiol ; 231: 116-119, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30955798

RESUMO

The use of immunomodulators is a promising alternative to the use of antibiotics for therapeutic, prophylactic, and metaphylactic use to prevent and combat infectious disease. Previously we demonstrated a replication-defective adenovirus vector that expresses porcine granulocyte colony-stimulating factor (G-CSF) elicited a sustained neutrophilia, lasting nearly 3 weeks, which may be beneficial to prevent bacterial diseases during times of peak incidence. In a pilot study using the vectored G-CSF with a Caesarian-derived, colostrum-deprived (CDCD) pig model of Streptococcus suis disease, only 1 of 4 pigs given G-CSF developed disease, while 3 of 4 non-treated pigs developed Streptococcal disease. In a subsequent study using a larger number of pigs, although there was no difference in overall survival, there was a longer mean survival time in G-CSF treated pigs. S. suis infection is more severe in CDCD pigs than conventionally raised pigs, consequently results in the field may be superior to the ones reported in this study. Although there were positive effects from the use of G-CSF in this study, further research is needed to determine if improved clinical outcomes could be achieved under field conditions and whether the use of G-CSF in pigs to induce a sustained increase in circulating neutrophil numbers may be useful as an adjunct to antibiotics to diminish the severity of Streptococcal disease, especially during times of stress and pathogen exposure such as post-weaning.


Assuntos
Fator Estimulador de Colônias de Granulócitos/uso terapêutico , Neutrófilos/imunologia , Infecções Estreptocócicas/tratamento farmacológico , Streptococcus suis/efeitos dos fármacos , Suínos/imunologia , Adenoviridae/genética , Animais , Animais Recém-Nascidos , Modelos Animais de Doenças , Feminino , Vetores Genéticos , Imunomodulação , Injeções Intramusculares , Projetos Piloto , Gravidez , Infecções Estreptocócicas/mortalidade , Taxa de Sobrevida , Suínos/microbiologia
8.
PLoS One ; 14(4): e0214295, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30946761

RESUMO

BACKGROUND: Intrapartum antibiotic prophylaxis (IAP) to reduce the likelihood of neonatal early-onset group B streptococcal infection (EOGBS) has coincided with major reductions in incidence. While the decline has been largely ascribed to IAP following either universal screening or a risk-based approach to identify mothers whose babies may most benefit from IAP, there is lack of high quality evidence to support this view. AIMS: To describe management of maternal GBS colonisation in one local health district using universal screening and assess rates of EOGBS over time. METHODS: A retrospective cohort study was undertaken to describe compliance with GBS management, to determine the incidence of EOGBS and association between rates and maternal screening. Linking routinely collected maternity and pathology data, we explored temporal trends using logistic regression and covariates for potential effect modifiers. RESULTS: Our cohort included 62,281 women who had 92,055 pregnancies resulting in 93,584 live born babies. Screening occurred in 76% of pregnancies; 69% had a result recorded, 21.5% of those were positive for GBS. Prophylaxis was used by 79% of this group. Eighteen babies developed EOGBS, estimated incidence/1000 live births in 2006 and 2016 was 0.35 (95% CI, 0.07 to 0.63) and 0.1 (95% CI, 0 to 0.2) respectively. Seven of 10 term babies with EOGBS were born to mothers who screened negative. Data were unable to provide evidence of difference in rates of EOGBS between screened and unscreened pregnancies. We estimated the difference in EOGBS incidence from crude and weighted models to be 0 (95% CI, -0. 2 to 0.17) and -0.01 (95% CI, -0.13 to 0.10) /1000 live births respectively. CONCLUSION: No change was detected in rates of EOGBS over time and no difference in EOGBS in babies of screened and unscreened populations. Screening and prophylaxis rates were modest. Limitations of universal screening suggest alternatives be considered.


Assuntos
Antibioticoprofilaxia , Doenças do Recém-Nascido/epidemiologia , Doenças do Recém-Nascido/microbiologia , Triagem Neonatal , Infecções Estreptocócicas/epidemiologia , Streptococcus agalactiae/fisiologia , Idade de Início , Austrália/epidemiologia , Feminino , Humanos , Recém-Nascido , Doenças do Recém-Nascido/mortalidade , Gravidez , Nascimento Prematuro/microbiologia , Nascimento Prematuro/mortalidade , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/mortalidade
9.
Microb Pathog ; 131: 47-52, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30940607

RESUMO

This study determines the median lethal dose, and describes the clinico-pathological changes and disease development following Streptococcus agalactiae infection in Javanese medaka model. Javanese medakas were infected with S. agalactiae via intraperitoneal (IP) from 104 to 108 CFU/mL, and immersion (IM) route from 103 to 107 CFU/mL. The LD50-240h and clinico-pathological changes of the fish was determined until 240 h post infection (hpi). Next, the disease development was determined for 96 hpi in the fish following IP and IM infection at 103 CFU/mL and 104 CFU/mL, respectively. The LD50-240h of S. agalactiae in Javanese medaka was lower following IP injection (4.5 × 102 CFU/mL), compared to IM route (3.5 × 103 CFU/mL). The clinical signs included separating from the schooling group, swimming at the surface of water column, lethargy, erratic swimming pattern, corneal opacity and exophthalmia. Histopathological examinations revealed generalized congestion in almost all internal organs, particularly in liver and brain, while the kidney displayed tubular necrosis. Both IP and IM routes showed significant positive correlation (p < 0.05) between the CFU/g of S. agalactiae in the fish tissue and fish deaths. Moreover, the lesions for histopathological scoring in selected organs following IP and IM challenges were also reflecting the CFU/g and fish deaths. This study indicates the capability of Javanese medaka as a model organism in study of streptococcosis development.


Assuntos
Doenças dos Peixes/microbiologia , Oryzias/microbiologia , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/veterinária , Streptococcus agalactiae/patogenicidade , Animais , Encéfalo/patologia , Contagem de Colônia Microbiana , Modelos Animais de Doenças , Doenças dos Peixes/patologia , Injeções Intraperitoneais , Rim/patologia , Dose Letal Mediana , Fígado/patologia , Malásia , Morbidade , Necrose/patologia , Infecções Estreptocócicas/mortalidade , Infecções Estreptocócicas/patologia , Virulência
10.
Int J Antimicrob Agents ; 53(6): 850-854, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30851401

RESUMO

BACKGROUND: A variety of microorganisms can cause infective endocarditis (IE), with Staphylococci and Streptococci accounting for the majority of cases. Streptococci are a common cause of community-acquired IE but few studies have focused on this subgroup of endocarditis. METHODS: A retrospective multicentre study was conducted between 2012 and 2017 in 12 hospital centres in France. Data were extracted from the local diagnosis-related group database and matched with microbiological results. After identification, the records were retrospectively analysed. RESULTS: A total of 414 patients with streptococcal endocarditis were included. The patients were predominantly male (72.8%) and the median age was 73.2 years (interquartile range [IQR] 61.3-80.9). The majority of patients (70.6%) had native valve endocarditis. Embolic complications were seen in 38.8% of patients. Viridans group Streptococci (VGS) and bovis-equinus group Streptococci (BGS) accounted for 52.4% and 34.5% of isolated strains, respectively. Minimum inhibitory concentrations (MICs) of amoxicillin were <0.125, 0.125-2 and >2 mg/L for 59.6%, 27% and 1% of isolates, respectively. In-hospital mortality for patients with Streptococci-related IE was 17.8%. In multivariate analysis, the only factor associated with in-hospital mortality was MIC for amoxicillin between 0.25 and 2 mg/L (P = 0.04; OR = 2.23 [95% confidence interval (CI) 1.03-4.88]) whereas performance of cardiac surgery for IE was a protective factor (P = 0.001, OR = 0.23 [95% CI 0.1-0.56]). CONCLUSIONS: IE remains a serious and deadly disease despite recent advances in diagnosis and treatment. Adaptation of antibiotic doses to MICs for amoxicillin and surgery may improve patient outcome.


Assuntos
Amoxicilina/farmacologia , Antibacterianos/farmacologia , Endocardite/microbiologia , Infecções Estreptocócicas/microbiologia , Streptococcus/efeitos dos fármacos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Endocardite/epidemiologia , Endocardite/mortalidade , Feminino , França/epidemiologia , Hospitais , Humanos , Masculino , Testes de Sensibilidade Microbiana/métodos , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Risco , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/mortalidade , Streptococcus/classificação , Streptococcus/isolamento & purificação , Análise de Sobrevida , Adulto Jovem
11.
J Infect Chemother ; 25(5): 355-361, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-30744988

RESUMO

OBJECTIVES: ß-Hemolytic streptococci occasionally cause severe infections such as necrotizing fasciitis and streptococcal toxic shock syndrome (STSS). Here, we conducted a prospective study to investigate the production of cytokines and chemokines in patients with STSS to explore its pathogenesis in survivors and fatal cases. METHODS: From January 2013 through August 2015, all culture results from normally sterile sites were prospectively followed and screened for STSS. Clinical characteristics of the patients with STSS were evaluated and compared between survivors and fatal cases. Serum samples were collected on admission for quantification of various cytokines and chemokines. Bacterial strains were categorized by Lancefield grouping and analyzed for the emm type, and presence of speA, speB, speC, and speF. RESULTS: Fifteen patients received diagnosis of STSS. The median age of the patients was 60-year-old, and the mortality rate was 40% despite intensive treatment. Nine strains were categorized as group A, two belonged to group G, and four to group B. Group A contained various emm genotypes. Unexpectedly, potent proinflammatory cytokine levels such as TNF-α and IL-1ß were not significantly elevated, and comparison with surviving patients showed that IL-6, IL-8, and MCP-1 levels were significantly decreased and creatine kinase level was significantly elevated in fatally ill cases. CONCLUSION: Our results indicate that reduced production of proinflammatory cytokines and chemokines may be involved in STSS pathogenesis and critical for prognosis of patients with STSS.


Assuntos
Antibacterianos/uso terapêutico , Citocinas/sangue , Choque Séptico/sangue , Infecções Estreptocócicas/imunologia , Streptococcus/imunologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Citocinas/imunologia , Feminino , Genótipo , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico , Estudos Prospectivos , Sorogrupo , Choque Séptico/tratamento farmacológico , Choque Séptico/microbiologia , Choque Séptico/mortalidade , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/mortalidade , Streptococcus/genética , Streptococcus/isolamento & purificação , Sobreviventes/estatística & dados numéricos , Resultado do Tratamento
12.
BMC Infect Dis ; 19(1): 123, 2019 Feb 06.
Artigo em Inglês | MEDLINE | ID: mdl-30727961

RESUMO

BACKGROUND: There is a lack of data regarding the prevalence of invasive group B streptococcus (GBS) infection among neonates in China. This study aimed to investigate the incidence and mortality of invasive GBS infection and to identify the risk factors in our hospital. METHODS: Seventy-four cases admitted between January 2011 and December 2016 was included in this study. A retrospective matched case-control study was conducted in a tertiary maternity and paediatric hospital. Risk factors for the acquisition of invasive GBS infection and mortality were analysed by univariable and multivariable analysis. RESULTS: We collected and analysed data from 74 infants aged < 3 months with invasive GBS infection. Among 67,985 live births, we calculated an incidence of 1.09 per 1000 live births (95%CI:0.81-1.37%); the incidence of Early-onset GBS disease (EOD, n = 65) and Late-onset GBS disease (LOD, n = 9) were 0.96‰(95%CI:0.73-1.19%) and 0.13‰(95%CI:0.04-0.22%), respectively. Overall, pneumonia accounted 63.1% (41/65) of EOD, and sepsis accounted 88.9% (8/9) cases of LOD, respectively. The overall case fatality rate was 8.11% (6/74), including 7.69% (5/65) among cases of EOD and 11.1% (1/9) among cases of LOD. No predictor of mortality was found. Membrane stripping (P = 0.005, aOR: 3.68, 95% CI: 1.48-9.13) and non-resident mother (P < 0.001, aOR: 5.88, 95% CI: 2.36-14.61) were independent risk factors for EOD; no increased risk was found for LOD. CONCLUSIONS: This study demonstrates remarkable country-specific variation in comparison with other countries. Our findings can improve awareness of neonatal GBS infection and lay a cornerstone to ensure accurate representation of the burden.


Assuntos
Pneumonia Bacteriana/epidemiologia , Infecções Estreptocócicas/epidemiologia , Bacteriemia/epidemiologia , Bacteriemia/microbiologia , Estudos de Casos e Controles , China/epidemiologia , Feminino , Maternidades/estatística & dados numéricos , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Mortalidade , Mães/estatística & dados numéricos , Prevalência , Estudos Retrospectivos , Fatores de Risco , Infecções Estreptocócicas/mortalidade , Streptococcus agalactiae/isolamento & purificação
13.
Eur J Clin Microbiol Infect Dis ; 38(3): 457-465, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30680552

RESUMO

We aimed to investigate the relationship between time to positivity (TTP) of blood cultures and clinical outcomes in children with S. pneumoniae bacteremia. Children with S. pneumoniae bacteremia hospitalized in Children's Hospital of Chongqing Medical University from May 2011 to December 2017 were enrolled retrospectively. Overall, 136 children with S. pneumoniae bacteremia were enrolled. The standard cutoff TTP was 12 h. We stated that in-hospital mortality is significantly higher in the early TTP (≤ 12 h) group than that in the late TTP (> 12 h) group (41.70% vs 8.00%, P < 0.001). Septic shock occurred in 58.30% of patients with early TTP and in 21.00% of patients with late TTP (P < 0.001). Independent risk factors of in-hospital mortality and septic shock in children with S. pneumoniae bacteremia included early TTP, need for invasive mechanical ventilation, and PRISM III score ≥ 10. Overall, TTP ≤ 12 h appeared to associate with the worse outcomes for children with S. pneumoniae bacteremia.


Assuntos
Bacteriemia/diagnóstico , Hemocultura/estatística & dados numéricos , Infecções Estreptocócicas/diagnóstico , Streptococcus pneumoniae/isolamento & purificação , Bacteriemia/epidemiologia , Bacteriemia/mortalidade , Pré-Escolar , Feminino , Mortalidade Hospitalar , Humanos , Lactente , Masculino , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Choque Séptico/epidemiologia , Choque Séptico/mortalidade , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/mortalidade , Streptococcus pneumoniae/crescimento & desenvolvimento , Fatores de Tempo
14.
J Fish Dis ; 42(1): 11-19, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30374993

RESUMO

Streptococcus agalactiae is a major pathogen of tilapia causing significant economic losses for the global aquatic industry yearly. To elucidate the role of cel-EIIB protein-mediated phosphotransferase systems (PTS) in the virulence regulation of S. agalactiae, cel-EIIB gene deletion in a virulent strain THN0901 was achieved by homologous recombination. The cellobiose utilization of △cel-EIIB strain was significantly decreased relative to S.a.THN0901 strain incubating in LB with 10 mg/ml cellobiose (p < 0.05). The biofilm formation ability of △cel-EIIB strain was also significantly decreased when cultured in BHI medium (p < 0.05). Under a lower infection dose, the accumulative mortality of tilapia caused by △cel-EIIB strain was dramatically decreased (20%), of which S.a.THN0901 strain and △cel-EIIB::i strain were 53.33% and 50%, respectively. The competition experience using tilapia model indicated the invasion and colonization ability of △cel-EIIB strain was significantly weaker than that of S.a.THN0901 strain (p < 0.05). Compared to △cel-EIIB::i strain, the mRNA expression of csrS, csrR, rgfA, rgfC, bgrR and bgrS was significantly downregulated in △cel-EIIB strain (p < 0.05). In conclusion, cel-EIIB protein-mediated cel-PTS not only contributes to biofilm formation and virulence regulation, but also plays an important role in the invasion and colonization of S. agalactiae.


Assuntos
Doenças dos Peixes/microbiologia , Infecções Estreptocócicas/veterinária , Streptococcus agalactiae/genética , Streptococcus agalactiae/patogenicidade , Virulência/genética , Animais , Biofilmes , Celobiose/metabolismo , Ciclídeos/microbiologia , Doenças dos Peixes/mortalidade , Doenças dos Peixes/patologia , Infecções Estreptocócicas/mortalidade , Infecções Estreptocócicas/patologia , Streptococcus agalactiae/metabolismo
15.
J Infect Chemother ; 25(1): 41-44, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30377069

RESUMO

The present retrospective study provides an in-depth analysis of the maternal sepsis-related deaths reported in Japan, and aims to guide future care regarding maternal sepsis. This is a nationwide, retrospective, descriptive cohort study. Data were retrospectively analyzed on all maternal death cases related to sepsis reported in Japan from 2010 through 2016. A total of 7,347,727 births and 317 maternal deaths were reported during the study period. The cause of maternal death was sepsis in 24 women (7.5%). Causative bacteria were Streptococcus pyogenes (54.2%), Chlamydia psittaci (8.3%), Mycobacterium tuberculosis (8.3%), Escherichia coli (4.2%), Neisseria meningitidis (4.2%), Epstein-Barr virus (4.2%), and unknown (16.6%). In maternal death due to S. pyogenes (13 women), onset periods ware antepartum in 10 women (76.9%) and postpartum in 3 (23.1%); death within 24 h after hospital admission occurred in 7 women (53.8%); and the median time from hospital admission to death was 12 h (6-744 h). The most common causative bacteria in to maternal sepsis-related death were GAS. When encountering severe sepsis during the peripartum period, we recommend considering severe GAS infection and early intervention.


Assuntos
Mortalidade Materna , Complicações Infecciosas na Gravidez/microbiologia , Complicações Infecciosas na Gravidez/mortalidade , Infecções Estreptocócicas/microbiologia , Infecções Estreptocócicas/mortalidade , Streptococcus pyogenes/isolamento & purificação , Adulto , Chlamydophila psittaci/genética , Chlamydophila psittaci/isolamento & purificação , Estudos de Coortes , Escherichia coli/genética , Escherichia coli/isolamento & purificação , Feminino , Herpesvirus Humano 4/genética , Herpesvirus Humano 4/isolamento & purificação , Humanos , Mycobacterium tuberculosis/genética , Mycobacterium tuberculosis/isolamento & purificação , Neisseria meningitidis/genética , Neisseria meningitidis/isolamento & purificação , Período Pós-Parto , Gravidez , Complicações Infecciosas na Gravidez/sangue , Estudos Retrospectivos , Infecções Estreptocócicas/sangue , Infecções Estreptocócicas/complicações , Streptococcus pyogenes/genética , Inquéritos e Questionários , Adulto Jovem
16.
Neonatology ; 115(2): 127-133, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30419568

RESUMO

BACKGROUND: Animal models suggest that neuroprotective effects of therapeutic hypothermia (TH) after perinatal asphyxia are reduced in infants with early-onset sepsis. OBJECTIVES: To assess the outcome of infants with perinatal asphyxia, neonatal encephalopathy, and TH in the presence of early-onset sepsis. METHODS: In a retrospective cohort of 1,084 infants with perinatal asphyxia and TH, the outcome of 42 infants (gestational age 36.1-42.6 weeks and birth weight 2,280-5,240 g) with proven sepsis (n = 14) and probable sepsis (n = 28) was analyzed. Death, cerebral palsy, or a delayed development at 2 years was considered an adverse outcome. RESULTS: Sepsis was caused mostly by group B streptococci (n = 17), other Gram-positive bacteria (n = 5), and Candida albicans (n = 1). Of the 42 infants, 9 (21.4%) died, and 5 (11.9%) showed impairments on follow-up. The outcome is comparable to the previously reported outcome of infants with TH without early-onset sepsis. CONCLUSION: A good outcome was reported in the majority of infants with perinatal asphyxia, TH, and early-onset sepsis. Cooling should not be withheld from these infants.


Assuntos
Asfixia Neonatal/terapia , Encefalopatias/complicações , Hipotermia Induzida , Sepse/complicações , Infecções Estreptocócicas/complicações , Idade de Início , Bélgica , Encefalopatias/mortalidade , Paralisia Cerebral/prevenção & controle , Deficiências do Desenvolvimento/prevenção & controle , Feminino , Idade Gestacional , Humanos , Lactente , Recém-Nascido , Masculino , Países Baixos , Estudos Retrospectivos , Sepse/microbiologia , Sepse/mortalidade , Infecções Estreptocócicas/mortalidade
17.
Eur J Clin Microbiol Infect Dis ; 38(2): 265-275, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30430377

RESUMO

A comparative study of the behaviour of left-sided infective endocarditis (left-sided IE) due to Streptococcus agalactiae (GBS) with left-sided IE caused by Staphylococcus aureus (SA). A prospective, multicentre cohort study in eight public hospitals in Spain, from January 1984 to December 2015; comparative analysis and factors associated with mortality. In total, there were 1754 episodes of left-sided IE; 41 (2.3%) caused by GBS vs. 344 (19.6%) due to SA, definitive IE 39 vs. 324 cases, males, 25 vs. 213, respectively. There were no differences in age or comorbidity, and healthcare-associated acquirement was 10% vs. 43%, p 0.001. Transthoracic echocardiogram (TTE) was performed in 95% vs. 96.8% and a transesophageal echocardiogram (TEE) in 61% vs. 56%. Vegetations were detected in 80% and measured > 1 cm in a similar proportion. It affected native valves in 85.4% vs. 82.6% and late prosthetic valve in 14.6% vs. 9.6%. The course was acute in both groups. There were more skin manifestations in SA left-sided IE, 7.3% vs. 32%, p 0.001. Both groups had similar complications, but in SA, there was more renal failure, 24% vs. 45%, p 0.010. Surgical risk and operated patients were similar. Mortality was proportionally higher in the SA group, without significance 29% vs. 43% (150), p 0.09. Heart failure, septic shock and neurological deterioration conditioned mortality: HR 1.96, 1.69 and 1.37 (CI 95% 1.40-2.73; 1.19-2.39 and 0.99-1.88 respectively) and to a lesser degree SA as aetiology agent and age. Left-sided IE caused by GBS is similar in severity to left-sided IE caused by SA.


Assuntos
Endocardite Bacteriana/epidemiologia , Endocardite Bacteriana/patologia , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/patologia , Streptococcus agalactiae , Idoso , Infecção Hospitalar/epidemiologia , Endocardite Bacteriana/etiologia , Endocardite Bacteriana/mortalidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Espanha/epidemiologia , Infecções Estafilocócicas/complicações , Infecções Estafilocócicas/epidemiologia , Infecções Estafilocócicas/mortalidade , Infecções Estafilocócicas/patologia , Staphylococcus aureus , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/mortalidade
18.
Medicine (Baltimore) ; 97(50): e13607, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30558035

RESUMO

The accuracy of matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) for identifying viridans group streptococcus (VGS) was improving. However, the clinical impact of identifying VGS had not been well recognized. Our study had comprehensively studied the clinical manifestations and outcome of VGS blood stream infection by using MALDI-TOF MS for identification.This retrospective study enrolled 312 adult patients with a monomicrobial blood culture positive for VGS. Blood culture was examined through MALDI-TOF MS.The most common VGS species were the Streptococcus anginosus group (38.8%) and Streptococcus mitis group (22.8%). Most species showed resistance to erythromycin (35.6%), followed by clindamycin (25.3%) and penicillin (12.5%). Skin and soft tissue infection and biliary tract infection were significantly related to S. anginosus group bacteremia (P = .001 and P = .005, respectively). S. mitis group bacteremia was related to infective endocarditis and bacteremia with febrile neutropenia (P = .005 and P < .001, respectively). Infective endocarditis was also more likely associated with S. sanguinis group bacteremia (P = .009). S. anginosus group had less resistance rate to ampicillin, erythromycin, clindamycin, and ceftriaxone (P = .019, <.001, .001, and .046, respectively). A more staying in intensive care unit, underlying solid organ malignancy, and a shorter treatment duration were independent risk factors for 30-day mortality. This study comprehensively evaluated different VGS group and their clinical manifestations, infection sources, concomitant diseases, treatments, and outcomes. Categorizing VGS into different groups by MALDI-TOF MS could help clinical physicians well understand their clinical presentations.


Assuntos
Bacteriemia/etiologia , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/métodos , Estreptococos Viridans/patogenicidade , Adulto , Idoso , Idoso de 80 Anos ou mais , Bacteriemia/epidemiologia , Bacteriemia/mortalidade , Hemocultura/métodos , Hemocultura/estatística & dados numéricos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Sensibilidade e Especificidade , Espectrometria de Massas por Ionização e Dessorção a Laser Assistida por Matriz/estatística & dados numéricos , Infecções Estreptocócicas/complicações , Infecções Estreptocócicas/epidemiologia , Infecções Estreptocócicas/mortalidade , Taiwan/epidemiologia , Estreptococos Viridans/crescimento & desenvolvimento
19.
Rev Chilena Infectol ; 35(4): 424-430, 2018 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-30534930

RESUMO

BACKGROUND: Group B Streptococcus (GBS) disease remains the leading cause of early-onset sepsis (EOS) in developed countries despite effective prophylaxis strategies. AIMS: To describe the incidence, clinical features and mortality of GBS EOS in infants born at Centro Hospitalario Pereira Rossell (CHPR) and analyse failure of adherence to prevention strategies. METHODS: Retrospective review of EOS cases between 2007 and 2015 collected from the bacteriology laboratory database. RESULTS: Fifteen cases of GBS EOS were identified, with an incidence of 0.23% during the study period. Intrapartum antibiotic prophylaxis (IAP) was not administered in any of the cases. All infants were symptomatic within the first 15 hours of life, mainly due to respiratory signs (80%). In one case, GBS was isolated from spinal fluid. Mortality rate was 20%. All deaths occurred in the first 24 hours of life, corresponding two thirds to preterm infants. CONCLUSION: The incidence of GBS EOS at CHPR was similar to other centers where IAP is implemented. Better adherence to prophylaxis strategies could reduce the incidence.


Assuntos
Transmissão Vertical de Doença Infecciosa/estatística & dados numéricos , Complicações Infecciosas na Gravidez/mortalidade , Sepse/mortalidade , Sepse/prevenção & controle , Infecções Estreptocócicas/mortalidade , Infecções Estreptocócicas/prevenção & controle , Adolescente , Adulto , Antibacterianos/uso terapêutico , Antibioticoprofilaxia , Feminino , Humanos , Incidência , Recém-Nascido , Recém-Nascido Prematuro , Transmissão Vertical de Doença Infecciosa/prevenção & controle , Gravidez , Complicações Infecciosas na Gravidez/diagnóstico , Complicações Infecciosas na Gravidez/microbiologia , Complicações Infecciosas na Gravidez/prevenção & controle , Estudos Retrospectivos , Sepse/diagnóstico , Sepse/tratamento farmacológico , Infecções Estreptocócicas/tratamento farmacológico , Infecções Estreptocócicas/microbiologia , Streptococcus agalactiae/isolamento & purificação , Adulto Jovem
20.
BMC Genomics ; 19(1): 907, 2018 Dec 12.
Artigo em Inglês | MEDLINE | ID: mdl-30541452

RESUMO

BACKGROUND: Swine streptococcosis has caused great economic loss in the swine industry, and the major pathogen responsible for this disease is Streptococcus Suis serotype 2 (SS2). Disease resistance breeding is a fundamental way of resolving this problem. With the development of GWAS and transcriptomic microarray technology, we now have powerful research tools to identify SS2 resistance genes. RESULTS: In this research, we generated an F2 generation of SS2 resistant C57BL/6 and SS2 susceptive A/J mice. With the F2 generation of these two mice strains and GWAS analysis, we identified 286 significant mouse genome SNPs sites associated with the SS2 resistance trait. Gene expression profiles for C57BL/6 and A/J were analyzed under SS2 infection pressure by microarray. In total, 251 differentially expressed genes were identified between these two mouse strains during SS2 infection. After combining the GWAS and gene expression profile data, we located two genes that were significantly associated with SS2 resistance, which were the UBA domain containing 1 gene (Ubac1) and Epsin 1 gene (Epn 1). GO classification and over-representation analysis revealed nine up-regulated related to immune function, which could potentially be involved in the C57BL/6 SS2 resistance trait. CONCLUSION: This is the first study to use both SNP chip and gene express profile chip for SS2 resistance gene identification in mouse, and these results will contribute to swine SS2 resistance breeding.


Assuntos
Resistência à Doença/genética , Perfilação da Expressão Gênica/métodos , Estudo de Associação Genômica Ampla , Streptococcus suis/patogenicidade , Transcriptoma , Proteínas Adaptadoras de Transporte Vesicular/genética , Animais , Feminino , Genoma , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Análise de Sequência com Séries de Oligonucleotídeos , Polimorfismo de Nucleotídeo Único , Sorogrupo , Infecções Estreptocócicas/genética , Infecções Estreptocócicas/mortalidade , Infecções Estreptocócicas/veterinária , Streptococcus suis/metabolismo , Taxa de Sobrevida , Complexos Ubiquitina-Proteína Ligase/genética
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